Last reviewed: 1 Sep 2023
Last updated: 26 Aug 2020
Summary
Definition
History and exam
Key diagnostic factors
- hearing loss
- ear discharge resistant to antibiotic therapy
- attic crust in retraction pocket
- white mass behind intact tympanic membrane
More key diagnostic factors
Other diagnostic factors
- tinnitus
- otalgia
- altered taste
- dizziness
- facial nerve weakness
Other diagnostic factors
Risk factors
- middle ear disease
- eustachian tube dysfunction
- otologic surgery
- traumatic blast injury to ear
- congenital anomalies
- family history
More risk factors
Diagnostic investigations
1st investigations to order
- pure tone audiogram
- CT scan of the petrous temporal bones
More 1st investigations to order
Investigations to consider
- fistula test
- MRI scan of the head and petrous temporal bones
- bacterial culture
More investigations to consider
Treatment algorithm
ACUTE
all patients
Contributors
Authors
Susan A. Douglas, MBBS (Hons) UWI, FRCSEd, FRCS (ORL-HNS)
Consultant Otolaryngologist and Otologist
Rotherham NHS Foundation Trust
Rotherham
UK
Disclosures
SAD declares that she has no competing interests.
Peer reviewers
Cliff Megerian, MD
Professor and Vice Chairman of Otolaryngology
Case Western Reserve University School of Medicine
Cleveland
OH
Disclosures
CM is an author of a reference cited in this topic.
Iain Swan, MD, FRCS
Senior Lecturer in Otolaryngology
Honorary Consultant Otolaryngologist
Glasgow Royal Infirmary
Glasgow
UK
Disclosures
IS declares that he has no competing interests.
Differentials
- Chronic suppurative otitis media
- Otitis externa
- Benign necrotizing otitis externa
More DifferentialsGuidelines
- ACR appropriateness criteria: hearing loss and/or vertigo
More GuidelinesPatient leaflets
Middle ear infection
Outer ear infection
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